The long-term research goal is to identify predictors of spoken language development in profoundly deaf children who receive a cochlear implant (CI). Decades of research have demonstrated that children with severe-to-profound deafness (including children who receive a CI), on average, exhibit deficits in language and literacy as compared to their normally-hearing (NH) peers (e.g., Geers, 2004; Miller, 2009; Paul, 1998). These literacy and spoken language deficits are thought to be responsible for the significant academic achievement gaps that are observed between deaf and NH children (e.g., Harris & Beech, 1998). Further research is needed to determine the skills underlying spoken language development in deaf children so that more effective early intervention strategies can be developed. The goal of the proposed project is to compare cognitive skills (known to be important for language acquisition) in children with profound hearing loss to those of children with NH and to examine the relationship between a nonverbal cognitive skill (VSL ability) and spoken language ability. The first specific aim is to examine visual sequence learning (VSL) in infants aged 8 to 23 months with severe-to-profound deafness that will be undergoing cochlear implantation. Their performance on the VSL task will be compared to the performance of aged-matched infants with NH. Infants with CIs will be tested on the VSL task just prior to the initial activation of their CI (i.e., prior to auditory input). Differences in performance between the two groups will serve as an index of the effects of early auditory deprivation on VSL ability. The second specific aim is to determine the relationship between VSL ability and later spoken language in deaf infants who use CIs. Correlational analyses will be conducted between scores on the VSL task prior to cochlear implantation and vocabulary and grammatical scores on the MacArthur-Bates Communicative Development Inventories (CDIs; Fenson et al., 2006) one year following cochlear implantation. Because language development begins at birth, infancy is an opportune time to investigate predictors of spoken language ability. A potential clinical implication of this work is the identification of early nonverbal predictors of spoken language outcome, which may be used in the future to develop new early intervention strategies designed to promote spoken language development. These strategies may narrow the achievement gap between NH and deaf children. A strong positive correlation between VSL in infancy and spoken language ability one year later would suggest that early sequence learning skills are important for spoken language development. In contrast, a weak correlation might suggest that VSL ability is not that important for spoken language development in deaf infants. Either pattern of results clarifies the effects of auditory deprivation on the development of cognitive skills that underlie spoken language development. PUBLIC HEALTH RELEVANCE: This research addresses the issue of why some deaf children with cochlear implants learn spoken language very well while others have poor language outcomes and, consequently, struggle with developing literacy skills and perform poorly in school. Discovering early predictors of language outcomes will enable clinicians to identify infants who are at risk for poor language outcomes and design appropriate early intervention strategies to reduce the chances that they will not develop adequate language to succeed in school.